title: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis: an unusual cause of autistic regression in a toddler.
abstract: Anti N-methyl-d-aspartate (NMDA) receptor encephalitis in children is associated with psychiatric changes, seizures, and dyskinesias. We present the first report of autistic regression in a toddler caused by this entity. A 33-month-old boy presented with decreased appetite, irritability, and insomnia following an upper respiratory tract infection. Over the next few weeks he lost language and social skills, and abnormal movements of his hand developed. Within a month, this patient came to fit the diagnostic criteria for autistic spectrum disorder. Upon investigation, anti-NMDA receptor antibodies were found in the boy's cerebrospinal fluid. He was treated with intravenous immunoglobulins and steroids, resulting in reacquisition of language and social skills and resolution of movements. Our case emphasizes the significance of suspecting anti-NMDA receptor encephalitis as the cause of autistic regression, even in an age group where the diagnosis of autistic spectrum disorder is typically made, and especially when presentation follows a febrile illness.
authors.affiliation: 1Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Ori
authors.initials: O
authors.lastname: Scott
authors.forename: Lawrence
authors.initials: L
authors.lastname: Richer
authors.forename: Karen
authors.initials: K
authors.lastname: Forbes
authors.forename: Lyn
authors.initials: L
authors.lastname: Sonnenberg
authors.forename: Angela
authors.initials: A
authors.lastname: Currie
authors.forename: Myroslava
authors.initials: M
authors.lastname: Eliyashevska
authors.forename: Helly R
authors.initials: HR
authors.lastname: Goez
mesh_terms: D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000150:complications*; D001321:Autistic Disorder / Q000209:etiology*; D002675:Child, Preschool; D006801:Humans; D008297:Male
keywords: Autistic spectrum disorder; anti-NMDA receptor encephalitis; autoimmune autistic regression